Lipoprotein Characteristics and Incident Coronary Heart Disease: Prospective Cohort of Nearly 90 000 Individuals in UK Biobank

Oct 10, 2023Journal of the American Heart Association

Lipoprotein features linked to new cases of coronary heart disease in nearly 90,000 UK Biobank participants

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Abstract

The study analyzed data from 89,422 participants and found positive associations of coronary heart disease (CHD) risk with concentrations of very-low-density lipoproteins, intermediate-density lipoproteins, and low-density lipoproteins.

CHD risk increased with higher concentrations of very-low-density lipoproteins (hazard ratio: 1.22), intermediate-density lipoproteins (1.16), and low-density lipoproteins (1.20).
Conversely, higher concentrations of high-density lipoproteins were inversely associated with CHD risk (hazard ratio: 0.90).
Larger subclasses of very-low-density lipoproteins were less strongly related to CHD risk, indicating size may play a role.
Lipid composition, including cholesterol levels, showed weak links to CHD risk, except for triglycerides found in LDL particles.
Apolipoprotein B was closely correlated with LDL concentrations, but after adjusting for it, very-low-density lipoprotein and high-density lipoprotein particle concentrations remained significantly associated with CHD risk.

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Background Associations of coronary heart disease (CHD) with plasma lipids are well described, but the associations with characteristics of lipoproteins (which transport lipids) remain unclear. Methods and Results UK Biobank is a prospective study of 0.5 million adults. Analyses were restricted to 89 422 participants with plasma lipoprotein and apolipoprotein measures from Nightingale nuclear magnetic resonance spectroscopy and without CHD at baseline. CHD risk was positively associated with concentrations of very-low-density lipoproteins, intermediate-density lipoproteins, and low-density lipoproteins (LDL), and inversely associated with high-density lipoproteins. Hazard ratios (99% CIs) per SD were 1.22 (1.17-1.28), 1.16 (1.11-1.21), 1.20 (1.15-1.25), and 0.90 (0.86-0.95), respectively. Larger subclasses of very-low-density lipoproteins were less strongly associated with CHD risk, but associations did not materially vary by size of LDL or high-density lipoprotein. Given lipoprotein particle concentrations, lipid composition (including cholesterol) was not strongly related to CHD risk, except for triglyceride in LDL particles. Apolipoprotein B was highly correlated with LDL concentration (=0.99), but after adjustment for apolipoprotein B, concentrations of very-low-density lipoprotein and high-density lipoprotein particles remained strongly related to CHD risk. Conclusions This large-scale study reliably quantifies the associations of nuclear magnetic resonance-defined lipoprotein characteristics with CHD risk. CHD risk was most strongly related to particle concentrations, and separate measurements of lipoprotein concentrations may be of greater value than the measurement by apolipoprotein B, which was largely determined by LDL concentration alone. Furthermore, there was strong evidence of positive association with mean triglyceride molecules per LDL particle but little evidence of associations with total triglycerides or other lipid and lipoprotein fractions after accounting for lipoprotein concentrations. r

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Lipoprotein Characteristics and Incident Coronary Heart Disease: Prospective Cohort of Nearly 90 000 Individuals in UK Biobank

Abstract

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